How to Handle Ebola Waste Management in the US

ebola-wasteUS Hospitals Unprepared to Handle Ebola Waste if you’ve been following the news recently you may have seen this headline. What is the concern? Why did other waste management companies refuse to take the waste? Here’s a short summary of the issue:

DOT will not allow shipment of any waste materials related to Ebola patient care if the material has the potential to contain the Ebola virus. This means, in order to safely dispose of this waste according to DOT requirements it would need to be sterilized on site and then shipped in special packaging by hazmat trained employees. Unless a hospital has the capability of sterilization on site, which is not the case for many smaller hospitals, the waste can’t be transported.

This is a problem that requires input from the CDC, DOT, healthcare institutions and waste management providers.  Until a determination on best management procedures is developed, we’ve identified some best practices based on CDC guidelines.  You can implement these practices to be better prepared in the event of an Ebola outbreak.

Prior to Ebola Arrival

Prior to the arrival of a potentially infected Ebola patient, take the time to create a specific procedure if you don’t yet already have one.  As both CDC and DOT are trying to find the safest procedure, it’s important that you read these recommendations and train all involved employees. The CDC has created checklists as well as signage that can be hung as a continuous reminder to employees in post-training preparation for Ebola.

As part of the preparation plan, we recommend that smaller hospitals do an audit of their PPE and make considerations as to where an Ebola patient will be cared for at your hospital.

Ensure you have the correct materials to sterilize the environment of the Ebola patient and the correct containers to dispose of Ebola related waste temporarily until it’s sterilized. 

If Ebola Arrives

According to the CDC, there should be a daily cleaning of nonporous surfaces. The cleaning materials including rags, clothes and linens should be disposed of in a waste receptacle designed to support the bag to help minimize contamination of the bag’s exterior. 

The CDC recommends: “These materials should be placed in leak-proof containment and discarded as regulated medical waste. To minimize contamination of the exterior of the waste bag, place this bag in a rigid waste receptacle designed for this use. Incineration as a waste treatment process is effective in eliminating viral infectivity and provides waste minimization.”

Afterward: How to Dispose of Ebola Waste

Despite this advice, hospitals must prepare separate containers for this waste from ordinary regulated medical waste.  The DOT classifies Ebola as a Category A Infectious substance and requires extra steps be taken compared to traditional regulated medical waste before transportation.

The DOT requires ebal waste be disinfected before it is transported from your healthcasre facility. To comply, Emory, which treated two patients infected with Ebola, was able to disinfect the waste with their own autoclave. But as we stated earlier, many hospitals don’t have this equipment so  new solutions to safely dispose of this waste must be determined.  

One solution to this problem is treating Ebola waste with a sodium hypochlorite solution. This would act as a sterilant and eliminate the need for an autoclave, allowing hospitals to minimize risk and compliantly dispose of Ebola waste.


The prospect of Ebola in your facility is a new and complex issue that all healthcare institutions have to face. With understanding of the regulatory guidelines and careful and thorough preparation, both you and your employees can maximize your ability to prevent the spread of this infectious disease.

*All advice given in this article is based on guidelines taken from the CDC. You can access their full set of guidelines and recommendations here.

Have questions about the compliance of your healthcare facilities? Call us for a consultation.